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Lower urinary tract symptoms in men, age-related (including symptoms of benign prostatic hyperplasia/hypertrophy) - Management
Basis for recommendation

These recommendations are in line with the guideline The management of lower urinary tract symptoms in men from the National Institute for Health and Clinical Excellence (NICE) [NICE, 2010].

Furosemide

  • NICE found only one clinical trial, which reported that diuretics were more effective than placebo in reducing the frequency of night time urinating, but were not more effective in improving symptoms. These results may not be reliable, because there were only 43 participants in the study and the methods of randomization and allocation concealment were not reported [NICE, 2010].
  • NICE found no trial-based evidence on potential adverse effects (such as hypovolaemia and orthostatic hypotension), but considered the risk to be small (provided that this risk informs the information that is given to the man and the plans for monitoring) [NICE, 2010].

Desmopressin

  • NICE based their recommendation on expert opinion as they found only one crossover study; this was too small to provide reliable evidence [NICE, 2010].
  • NICE concluded that bioavailability and pharmacokinetic studies suggest that the nasal formulation of desmopressin may be more potent and more likely to cause hyponatraemia than the oral formulation (15 episodes per 100,000 patient-years with the nasal spray, and six episodes per 100,000 patient-years with the oral product) [NICE, 2010].

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